Clinical diagnosis of chronic canaliculitis by 20-MHz ultrasound.

The practical value of high-resolution ultrasound (transducer frequency of 20 MHz) in the study of the lacrimal canaliculi has been proven. It can also be used in the clinical diagnosis of chronic canaliculitis. If the classic symptoms are absent, the clinical diagnosis is often inaccurate, and treatment is insufficient. Representative images of normal cases and of chronic canaliculitis illustrate the potential of high-resolution ultrasound. In our patient, 20-MHz scanner images revealed pathological findings which were invisible during slitlamp examination. Ultrasonic images of chronic canaliculitis showed ectasia of the canaliculus and sulfur grains. High-resolution ultrasonic examination of the lacrimal drainage system demonstrated that the 20-MHz scanner used was able to show concrements (sulfur grains), measuring 1-2 mm in diameter. Such more reflective structures (like sulfur grains) are a pathognomonic sign of chronic canaliculitis. Our report confirms the efficiency of 20-MHz sonography in the diagnosis of canaliculitis without any side effects.